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World J Orthop. Nov 18, 2014; 5(5): 685-693
Published online Nov 18, 2014. doi: 10.5312/wjo.v5.i5.685
Management of proximal humerus fractures in adults
Leonidas Vachtsevanos, Lydia Hayden, Aravind S Desai, Asterios Dramis
Leonidas Vachtsevanos, Lydia Hayden, Department of Trauma and Orthopaedics, Abertawe Bro Morgannwg University Health Board, Swansea SA6 6NL, United Kingdom
Aravind S Desai, Department of Trauma and Orthopaedics, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, NE7 7DN, United Kingdom
Asterios Dramis, Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff CF14 4XW, United Kingdom
Author contributions: Vachtsevanos L, Hayden L, Desai AS, Dramis A contributed to conception and design of the study, analysis and interpretation of data; Vachtsevanos L, Hayden L performed the literature review; Vachtsevanos L drafted the article; Dramis A, Desai AS revised the article; all the authors read and approved the final manuscript.
Correspondence to: Asterios Dramis, BM, MSc, MRCS, FEBOT, FRCS (Orth), Senior Trauma Fellow, Department of Trauma and Orthopaedics, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom.
Telephone: +44-12-14403044 Fax: +44-29-20716310
Received: January 29, 2014
Revised: July 6, 2014
Accepted: July 15, 2014
Published online: November 18, 2014
Core Tip

Core tip: Non-operative management is associated with good outcomes in the majority of proximal humerus fractures in adults. There is currently insufficient evidence to suggest superiority of one treatment option over the others. Any surgical intervention should have clear aims and indications and the appropriate technique should be selected for each individual patient. Decision-making should involve detailed fracture evaluation, careful patient selection with thorough consideration of individual patient characteristics, comorbidities and functional expectations and profound understanding of the benefits and limitations of each management option.